Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NRSG 102: Med Surg 1 > Exam 1: Chapter 55 > Flashcards

Exam 1: Chapter 55 Flashcards

1
Q

Lower UTIs include

A

Bacterial Cystitis
Bacterial Prostatitis
Bacterial Urethritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Upper UTIs are less common and include

A

Acute or Chronic Pyelonephritis, Interstitial Nephritis and Kidney Abscesses.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Uncomplicated Lower or Upper UTIs

A

Community-acquired infection; common in young women and not really recurrent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Complicated Lower and Upper UTIs

A

Often acquired in hospital and related to catheterization.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

For infection to occur in the Lower urinary Tract

A

Bacteria must gain access to the bladder, attach to and oclonize the epithelium of the urinary tract to avoid being washed out with voiding, evade host defense mechanisms and initiate inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is in the bladder to protect against bacteria?

A

Glycosaminoglycan (GAG) a protein that noramlly exerts a nonadherant protective effect against various bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Urethrovesical Reflux

A

An obstruction of free-flowing urinen which is the backflow of urine from the urethra into the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ureterovesical or Vesicoureteral Reflux

A

Refers to the backward flow of urine form the bladder into one or both uterers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Bacteriuria

A

The term used to describe the presence of bacteria in the urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What three ways can bacteria enter the urinary tract?

A 
Transurethral Route (Ascending Infection)
BLoodstream (Hematogenous Spread)
Means of a fistula from teh intestine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Most common route for infection?

A

TRansurethral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How big of a colony count is needed to indicate an infection?

A

Colony count greater than 100,000 CFU/mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can be seen on a microscopic level to indicate infection?

A

Hematuria (WBCS in the urine) and Pyuria with kidney stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Other studies to test for UTi?

A

Multiple-Test Dipstick, Leukocyte Esterase TEst and Nitrite TEsting.
Testing for Sexually TRansmitted Disease
XRay
CT Scan
Ultrasonography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Intake of what can help prevent and control symtpoms of UTI?

A

Cranberry juice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Pyelonephritis?

A

A bacterial infection of the renal plvis, tubules, and interstitial tissue of one or both kidneys.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What can acute Pyelonephritis lead to?

A

Enlargement of the kdineys with interstitial infiltrations of inflammatory cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What can chronic Pyelonephritis lead to?

A

Kidneys can become scarred, contracted, and nonfunctioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Clinical Manifestations for someone with Acute Pyelonephritis

A

Chills, Fevers, Leukocytosis, BActeriuria, Pyuria/

Low Back pain, flank pain, n/v, malaise, painful urination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What tests can be performed for Upper UTI

A

Untrasound Study or Ct Scan. Radionuclide Imaging with Gallium Citrate and Indium labeled WBCs may be useful to identify sites of infection that may not be visualized on CT scan.
Urine Culture Teest and Sensitivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is prescribed to outpatietns for Upper UTI

A

A 2 week course of antibiotic agents is recommended because renal parenchymal disease is more difficult to eradicate than mucosal bladder infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Signs of Chronic Pyelonephritis

A

Fatigue, HEadache, Poor Appetite, Polyuri, Excessive Thirst, And Weight Loss.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Chronic Pyelonephritis Complications

A

End-Stage Kidney Disease, Hypertension, and Formation of Kidney Stones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Signs and Symptoms of Uncomplicated Lower UTI

A

Burning on urination, urinary frequency, urgency, nocturia, incontinence and puprapubic or pelvin pain. Hematuria or back pain also present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Manifestations of Compliacted Lower UTI

A

Asymptomatic bacterium to gram negative sepsis with shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Results of what tests help confirm the diagnosis of UTI?

A

Bacteril colony counts, cellular studies, and urine cultures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Urine cultures useful for documenting

A

UTI and identifying the specific organism present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Microscopic hematuria is present in how many people with actue UTI?

A

half

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Pyuria can be seen in

A

UTI cases
Kidney Stones
Interstirial Nephritis
Renal Tuberculosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Lower UTIs: Multiple-Test dipstick often includes testing for

A

WBCs, known as leukocyte esterase test and nitrate testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Lower UTIs: Useful dagnostic tools?

A

X Ray Images
CT
Ultrasonography
Kidney Scans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Lower UTIs: CT scan may detect

A

pyeloephritis or abscesses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Lower UTIs: Ultrasonography and kidney scans are

A

extemely senstivie for detecting obstruction, abscesses, tumors, and cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Manaement of UTIs typically involves

A

pharmacologic therapy and patient education

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Lower UTIs: Ideal medication for treatment of uti is

A

an antibacterial agent that eradicates bacteria from the urinary tract with minimal effects on fecal and vaginal flora

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Lower UTIs: Acute short term treatment regimen typically lasts

A

3-7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Upper UTI: Pyeloephritis cause involves either

A

the upward spread of bacteria from the bladder or spread from systemic sources reaching the kidney via the blood stream

38
Q

Upper UTI: Ultrasound study or CT scan may be perform to locate

A

obstruction in the urinary tract

39
Q

Upper UTI: IV Pyelogram maybe indicated with pyelonephritis if

A

functional and structural renal abnormalities are suspected

40
Q

Upper UTI: Radionuclide imagine with gallium citrate and indium-111 labeled wbcs may be useful to identify

A

sites of infection that may not be visualized on CT scan or ultrasound

41
Q

Upper UTI: Urine culture and sensitivity tests are performed to determine

A

the causative organism so that appropriate antimicrobial agents can be prescribed

42
Q

Upper UTI: Patients with acute uncomplicated pyelonephritis are most often treated on outpatient basis if they are not exhibiting

A

acute symptoms of sepsis, dehydration , nausea or vomiting

43
Q

Upper UTI: Following acute pyelonephritis treatment, patient may develop chronic or recurring

A

syptomless infection persisting for months or years .

may need therapy 6 weeks if relapse occurs

44
Q

Upper UTI: What is obtained two weeks after completion of antibiotic therapy or acute pyelonephritis?

A

Urine culture, to document clearing of infection

45
Q

Upper UTI: What is essential for all patietns with UTIs?

A

Hydration with oral or PN fluids. Hydration helps facilitate “Flushing” of the urinary tract and reduces pain and discomofrt

46
Q

Upper UTI: Extent of Chronic Pyelonephritis assessed by

A

IV urogram and measurements of creatinine clearance, blood urea nitrogen, and creatinine levels.

47
Q

Upper UTI: What therapy will be used for Chronic Pyelonephritis?

A

Prophylactic antimicrobial therapy may help limit recurrence of infections and kidney scarring

48
Q

Upper UTI: Impaired kidney function alters

A

excretion of antimicrobial agents adn necessitates careful monitoring of kidney function

49
Q

Upper UTI: Nursing Management for Chronic Pyelonephritis: How much fluid is encouraged?

A

3-4 L.

Dilutes the urine, decrease burning on urination, and prevent dehydration

50
Q

What is Stress Incontinence?

A

Involuntary loss of urine through an intact urethra as result of sneezing, coughing, or changing position

51
Q

Stress Incontinence predominately affects who

A

women who have had vaginal deliveries and is throught to be result of decreasing ligament and pelvic floor support

52
Q

What is Urge Incontinence?

A

Involuntary loss of urine associated with a strong urge to void that cannot be suppressed

53
Q

Precipitaitng Factor of URge Incontinence?

A

Uninhibited detrusor contraction

54
Q

What is Functional Incontinence?

A

Instances in which lower urinary tract function is intact but other factors, such as severe cognitive impairement, make it difficult for the patient to identify the need to void or physical impairments make it difficult to reach toilet in time

55
Q

What is Iatrogenic Incontinence?

A

Involuntary lsos of urine due to extrinsic medical factors, prodominately medications

56
Q

What is Mixed Urinary Incontinence?

A

Encompases several types of urinary incontinence, is involuntary leaking associated with urgency and also with exertion, effort, sneezing, or coughing

57
Q

What can proboke the onset of urinary incontinence?

A

Acute UTI, infection, constipation, decreased fluid intake, and change in chronic disease pattern

58
Q

Medical management types for incontinence?

A

Behavioral Therapy
Pharmacologic Therapy
Surgical Management

59
Q

Incontinence: What is the cornerstone of behavioral intervention for addressing symptoms of stress, urge and mixed incontinece?

A

Pelvic floor muscle exercises (Kegel exercises)

60
Q

Chronic urine retnetion leads to

A

overflow incontinence (involuntary urine loss associated with overdistention of the bladder)

61
Q

Urinary retention may result from

A

diabetes, prostatic enlargement, urethral pathology, trauma, pregnancy, or neurologic disorders

62
Q

The retention of urine can lead to

A

chronic infection that predispose patient to renal calculi , pyelonephritis, sepsis or hydronephrosis

63
Q

Additional measures to promote urinary elimination include

A

applying warmth to relax the sphincter, giving the patient hot caffeine free beverage, and offer encouragement

64
Q

Urinary Retention: When the patient cannot void, what technique is performed?

A

Bladder scanning is used to assess for distension then straight catheterization is used to prevent overdistention of the bladder

65
Q

Urinary Retention: In the case of prostatic obstruction, what will be done

A

insertion of suprapubic cather (catheter inserted through a small abdominal incision into the bladder)

66
Q

Urinary REtention caused by

A

adults 60 years and older may have 50-100 mL of urine left in bladder

Postoperative spasms

Diabetes, prostatic enlargement, urethral pathology, truma, pregnancy

Medications

67
Q

Neurogenic Bladder: This is a

A

dysfunction frfom a disorder or dysfunction of the nervous system that leadss to urinary incontinence

68
Q

Neurogenic Bladder: caused by

A

spinal cord injury, spinal tumor, herniated vertebral disc, multiple sclerosis, congential disorders, infections, or complications of disabetes

69
Q

Neurogenic Bladder: Two types of neurogenic bladder?

A

Spastic (reflex) and flaccid bladder

70
Q

Neurogenic Bladder: What is the more common type?

A

Splastic bladder, and caused by any spinal cord lesion above the voiding reflex arc

71
Q

Neurogenic Bladder: Spastic bladder empties on

A

reflex,with minimal or no controlling influence to regulate its activity

72
Q

Neurogenic Bladder: Flaccid bladder caused by

A

a lower motor neuron lesion, commonly resulting from trauma

73
Q

Neurogenic Bladder: Flaccid bladder being recognized in patients with

A

diabetes

74
Q

Neurogenic Bladder: Wha thappens in Flaccid Bladder?

A

Bladder continues to fill and become sgreatly distended and overflow incontinence occcurs.

Muscle does not contract forcefully.

75
Q

Neurogenic Bladder: Assessment fo rhtis?

A

Measurement of fluid intake, urine output, and residual volume

Urinealysis

Assessment of sensory awareness

Comprehensive urodynamic studies performed

76
Q

Neurogenic Bladder: Most common complication is

A

infection resulting from urinary stasis and catheterization.
Others include renal calculi, impaired skin integrity, urinary incontinence or retention

77
Q

Neurogenic Bladder: Specififc interventions include

A

continuous, intermittent, or self-catherization ; the use of an external condom catheter ; diet low in calcium ; encouragement of mobility and ambulation

78
Q

Catherization: When urine cannot be eliminated naturally and must be draind artifially, what is done?

A

Catheters inserted into bladder, ureter, or renal pelvis

79
Q

Catherization: What are the four types of catheters/

A

Indwelling
Suprapubic
Condom
Indwelling

80
Q

Catherization - Indwelling Catheters: What catheter commonly used fter transurethral prostate surgery?

A

Triple-Lumen Catheter

81
Q

Catherization - Indwelling Catheters: What is the triple-lumen catheter

A

it is a triple lumen indwelling urethal catheter attached to a closed sterile drainage system .

82
Q

Catherization - Indwelling Catheters: Triple Lumen Catheter purpose of three ports?

A

Urinary drainage through one channel
Retention of balloon in inflated with water or air in second
Bladder continuously irrigated with sterile irrigating osolution through third

83
Q

Catherization - Indwelling Catheters: Why should the bag be lower than the patietns bladder?

A

Does not allow urine to flow back into the bladder

84
Q

Catherization - Suprapubic Catheter: These catheters allow bladder drainage by

A

inserting a catheter or tube into the bladder through a subprapubic incision or puncture. Catheter or drainage tube then threaded into bladder

85
Q

Catherization - Suprapubic Catheter: This may be a temporary measure to fivert flow of urine form the urethra when the

A

urethral route is impasable, after gynecologic or other abdominal surgery when dysfunction is to occur, or pelvis factures

86
Q

Catherization - Suprapubic Catheter: This may be maintained continuously for

A

several weeks

87
Q

Catherization - Suprapubic Catheter: When patietns abaility to pee is tested, catheter is

A

clamped for 4 hours .

After voiding, catheter is unclamped and residual urine is measure

88
Q

Catherization - Suprapubic Catheter: To avoid encrustation, patient requires

A

liberal amounts of fluid

89
Q

Catherization - Suprapubic Catheter: Other potential problems include

A

formation of bladder stones, acute or chronic infections, and problems colelcting urine

90
Q

Catheterization: Signs and symptoms of UTI?

A

Cloudly, malodorous urine, hematuria, fever, chills, anorexia, and malaise

91
Q

Catheterization: When an indwelling urinary catheter is in place , what muscle does not be used?

A

Detrusor muscles do not actively contract the bladder wall to stimulate emptying. They then may not respond to bladder filling resulting in urine retention or urinary incontinence

NRSG 102: Med Surg 1 (52 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions